Several endocrine disrupting chemicals, including, for example, bisphenol A (BPA), phthalates (ubiquitous plasticizers), polychlorinated dibenzodioxins (“dioxins”; byproducts of waste incineration), and DDE (a metabolite of DDT, an insecticide) have been linked to beta cell dysfunction and insulin resistance. Perhaps the most supportive evidence exists for persistent organic pollutants (“POPs”), a group of chemicals that includes dioxins, DDE and other organochlorine pesticide metabolites, and PCBs. We are exposed to low doses of POPs every day through contamination in our food supply, particularly through animal products such as fish, meat, and milk/milk products. Evidence is beginning to accumulate that ambient air pollution is also associated with glucose metabolism disorders. Thus, while traditional risk factors such as diet and exercise undoubtedly play a role in the development and progression of diabetes, further consideration of these novel environmental risk factors is needed.

Are your patients aware of the potential effect of endocrine disrupting chemicals on weight, beta cell function, and insulin sensitivity ? What, if any, interventions might be possible to reduce our exposure to these chemicals?

Information about the discussion leader

The discussion will be moderated by Lindsay Jaacks, PhD, Assistant Professor in the Department of Global Health and Population at Harvard University, USA.

References
1. Taylor KW et al. Evaluation of the association between persistent organic pollutants (POPs) and diabetes in epidemiological studies: a national toxicology program workshop review. Environ Health Perspect 2013;121(7):774-83
2. Rajagopalan S and Brook RD. Air pollution and type 2 diabetes. Diabetes 2012;61(12):3037-45.